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Original Research: COPD |

Mild Cognitive Impairment in Moderate to Severe COPDMild Cognitive Impairment in COPD: A Preliminary Study

Sylvia Villeneuve, PhD; Véronique Pepin, PhD; Shady Rahayel, BSc; Josie-Anne Bertrand, MPs; Myriam de Lorimier, PT; Amanda Rizk, MSc; Catherine Desjardins, MPs; Simon Parenteau, MD; François Beaucage, MD; Steve Joncas, PhD; Oury Monchi, PhD; Jean-François Gagnon, PhD
Author and Funding Information

From the Département de Psychologie (Dr Villeneuve and Ms Bertrand) and the Département de Radiologie (Dr Monchi), Université de Montréal; the Centre de Recherche (Drs Villeneuve and Monchi), Institut Universitaire de Gériatrie de Montréal; the Centre de Recherche (Drs Villeneuve, Pepin, and Gagnon; Mr Rahayel; and Mss Bertrand, de Lorimier, Rizk, and Desjardins) and the Service de Pneumologie (Drs Parenteau and Beaucage), Hôpital du Sacré-Coeur de Montréal; the Department of Exercise Science (Dr Pepin and Ms Rizk), Concordia University; and the Département de Psychologie (Mr Rahayel and Dr Gagnon), Université du Québec à Montréal, Montreal, QC; and the Geriatric Rehabilitation Service (Dr Joncas), Bruyère Continuing Care, Ottawa, ON, Canada.

Correspondence to: Jean-François Gagnon, PhD, Centre d’Études Avancées en Médecine du Sommeil, Hôpital du Sacré-Cœur de Montréal, 5400 boul Gouin ouest, Montréal, QC, H4J 1C5, Canada; e-mail: gagnon.jean-francois.2@uqam.ca


Funding/Support: This study was supported by grants from the Fonds de recherche du Québec-Santé (Drs Pepin and Gagnon), the Canadian Lung Association/Canadian Respiratory Health Professionals (Dr Pepin), the Faculté des sciences humaines de l’Université du Québec à Montréal (Dr Gagnon), and the Réseau provincial de recherche en adaptation-réadaptation (scholarship to Mr Rahayel).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(6):1516-1523. doi:10.1378/chest.11-3035
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Background:  Cognitive impairment is a frequent feature of COPD. However, the proportion of patients with COPD with mild cognitive impairment (MCI) is still unknown, and no screening test has been validated to date for detecting MCI in this population. The goal of this study was to determine the frequency and subtypes of MCI in patients with COPD and to assess the validity of two cognitive screening tests, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), in detecting MCI in patients with COPD.

Methods:  Forty-five patients with moderate to severe COPD and 50 healthy control subjects underwent a comprehensive neuropsychologic assessment using standard MCI criteria. Receiver operating characteristic curves were obtained to assess the validity of the MMSE and the MoCA to detect MCI in patients with COPD.

Results:  MCI was found in 36% of patients with COPD compared with 12% of healthy subjects. Patients with COPD with MCI had mainly the nonamnestic MCI single domain subtype with predominant attention and executive dysfunctions. The optimal MoCA screening cutoff was 26 (≤ 25 indicates impairment, with 81% sensitivity, 72% specificity, and 76% correctly diagnosed). No MMSE cutoff had acceptable validity.

Conclusions:  In this preliminary study, a substantial proportion of patients with COPD were found to have MCI, a known risk factor for dementia. Longitudinal follow-up on these patients is needed to determine the risk of developing more severe cognitive and functional impairments. Moreover, the MoCA is superior to the MMSE in detecting MCI in patients with COPD.

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